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Asthma Medication Cuts Kids' ER Visits

Inhaled corticosteroid reduced hospital trips by 29 percent

MONDAY, May 24, 2004 (HealthDayNews) -- If your child suffers from asthma, a drug called Pulmicort Respules may help keep him out of the emergency room.

Asthmatic children receiving the inhaled corticosteroid had significantly fewer ER visits and hospitalizations compared with children taking other asthma medications, Harvard Medical School researchers found.

"Among a large group of children who were seen in the ER or hospital and were followed for six months, the kids put on Pulmicort Respules had a 29 percent lower risk of returning to the ER or hospital than the children who were not on that medicine," said study leader Dr. Carlos A. Camargo, an associate professor of medicine.

The study, funded by AstraZeneca, the maker of Pulmicort Respules, was presented Monday at the American Thoracic Society meeting in Orlando, Fla.

Many people with asthma treat themselves with short-acting medications that give instant relief, Camargo noted.

"But this doesn't treat the problem, which is inflammation, and that's where corticosteroids are so effective and why they are the preferred therapy," he said.

Pulmicort Respules is an inhaled corticosteroid. It differs from other inhaled corticosteroids because it is delivered by a nebulizer rather than by an inhaler, Carmago said.

A nebulizer is a small plastic bowl with a screw-top lid where the medicine is placed, plus an air compressor. As compressed air enters the bowl, the nebulizer changes the medication into a mist.

This form of delivery has two advantages: First, the medication has a better chance to reach the small airways, increasing its effectiveness. Second, because parents have to prepare and supervise the delivery of the medication, they are more likely to see that their child consistently gets the drug, Carmago said.

"And the more often you use it, the more benefits you are going to derive from it," he said.

For the study, Carmago's team followed 10,167 children, up to 8 years of age, for six months. They compared Pulmicort Respules with other medicines that prevent asthma attacks.

"If you have a child who goes to the hospital or ER with asthma, the child should be on a medication to control asthma. You should talk to your doctor about what medicine is right. It could be this nebulized inhaled corticosteroid," Carmargo said.

Pediatric asthma is a persistent disease, according to Dr. William E. Berger, a pediatrics professor at the University of California, Irvine, and the author of Allergies and Asthma for Dummies.

"Patients that come for hospitalization with asthma are usually patients who are not well controlled," Berger said.

The results of the new study confirm what doctors who care for children with asthma have suspected, Berger added.

"We can prevent hospitalizations and ER visits if we use inhaled corticosteroids in these patients," he said.

Because children don't use inhalers very well, using a nebulized therapy is "probably the most effective way of giving inhaled corticosteroids to this age group," he added.

For the vast majority of children with asthma, it is a persistent disease. And the number one trigger is infection, Berger said.

"After they have been seen in the hospital, they should be followed on a regular basis by a physician," he said. "In the majority of cases, they are going to require an inhaled corticosteroid to keep them from having another episode that will require hospitalization or an ER visit."

More information

The National Institute of Allergy and Infectious Diseases can tell you more about asthma, and the National Heart, Lung, and Blood Institute has information on managing the disease.

SOURCES: Carlos A. Camargo, M.D., associate professor of medicine, Harvard Medical School, Boston; William E. Berger, M.D., clinical professor, department of pediatrics, University of California, Irvine, and past president, American College of Allergy, Asthma and Immunology, and author of Allergies and Asthma for Dummies; May 24, 2004, presentation, American Thoracic Society, Orlando, Fla.
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